COMPARISON OF DISTRACTION TECHNIQUE AND VALSALVA MANEUVER ON THE PAIN INTENSITY OF VENOUS CATHETER PLACEMENT: A RANDOMIZED, SINGLE-BLIND CLINICAL TRIAL
Journal Title: Nursing And Midwifery Journal - Year 2023, Vol 21, Issue 7
Abstract
Background & Aims: This study was conducted to compare the effect of the distraction technique and Valsalva maneuver methods on the pain intensity of peripheral venous catheter placement and examined the reduction of pain during these two interventions. Materials & Methods: This study is a randomized, single-blind clinical trial conducted on 100 patients aged 18-60 who needed to establish an intravenous line with a peripheral venous catheter, referring to Imam Khomeini Hospital, Esfrain between July and September 2019. Patients were allocated into two groups of 50 each. During the first venipuncture and IV line replacement, both distraction techniques and the Valsalva maneuver were performed in a cross-over method. In the distraction technique, the patients were asked to press a flexible rubber ball in their hand opposite the venipuncture as much as they could and hold it until the end of the venipuncture. In the Valsalva method, the patients were asked to perform a forced exhalation with their glottis closed while holding and squeezing the tip of their nose for 10 seconds. The patient's venipuncture pain was measured using the Visual Analogue Scale (VAS) before and after venipuncture. Paired t-test and independent t-test were used to compare the mean pain intensity, and SPSS software version 15.0 was used to analyze the data. The confidence coefficient of 95% was considered as significant in this study. Results: The period effect was insignificant, indicating that the washing period of 24 hours was appropriate in this study (P =0.48). The treatment-period interaction was significant (P <0.0001), and so, the groups were compared in the first treatment period and within the groups. Cross-over analysis using paired t-test and independent t-test showed no significant difference between the effect of the distraction method and Valsalva maneuver on the severity of pain of IV line insertion in the groups (P = 0.16). Conclusion: According to the results of this study, Valsalva maneuver and distraction techniques can be used as easy methods, without any cost, and without a need for special tools during the placement of venous catheters in order to reduce pain. The distraction technique can be used in the cases like cardiac patients that the Valsalva maneuver is prohibited.
Authors and Affiliations
Javad Sedaghati, abolfazal kalmishi
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